Medicare National Partnerships Operations Manager - Cigna Healthcare - Hybrid

What You’ll Do

The National Value-Based Contracting Account Owner Team is responsible for ensuring smooth end-to-end administration of contract operations for Cigna Medicare’s most advanced value-based provider partnerships and health systems. You must possess the energy to mobilize a matrixed team responsible for complex engagement of full risk providers. Responsibilities for this role include, but are not limited to:

• ​Oversees a team responsible for Provider operations and experience, providing concierge support for national value-based provider partners. Leads successful end-to-end implementation of national provider contracts, including but not limited to creation of network, downstream administration of risk requirements, data connectivity, value-based reporting structures, financial and membership reconciliation, and points of provider connectivity across the Cigna ecosystem.
• Manages national provider relationships that meet internal operational standards and external provider expectations of service excellence. Assists team in resolving escalated issues related to provider service complaints for national value-based providers. Researches problems and negotiates with internal/external partners to resolve highly complex and/or escalated issues, and proposes enterprise wide-strategies for process improvement based on both Cigna experience and industry trend.
• Serves as Subject Matter Expert for national contracting and reimbursement methodologies, operational systems and processes, and CMS policy and regulatory changes. Ensure downstream compliance with enterprise procedures for onboarding, implementation, and monitoring.
• Coordinates and aligns a framework of internal matrix partners to ensure delivery of operational excellence, including but not limited to: Provider Data Management, Provider Data Quality, Claims, Medical Management, Quality/STARS Credentialing, Legal, Medical Economics, Compliance, Sales and Marketing, Grievance, Appeals, Directory, and Provider Service.
• Owns end-to-end roster management, inclusive of roster audits and remediation efforts for national provider partners
• Executes department and enterprise-wide initiatives related to provider network design and value-based operations.
• Responsible for overseeing the development and maintenance of all contract information, drafting and maintenance of all National Partnerships policies and procedures, and supporting documentation. 
• Assist market Network/contracting teams with increasingly complex contracts and negotiations for sophisticated value-based reimbursements with Medicare provider partners. 
• People-leader, highly-matrixed role. Must work by influence/building relationships with others and ensuring effective and positive relationships across the Cigna organization.

Qualification:

• Bachelor’s degree or equivalent work experience
• 5+ years relevant experience with managed Medicare and provider engagement
• Experience in provider performance & enablement (PPE). Knowledge of value-based reimbursement structures and payment methodologies for providers is required.
• Experience navigating complex environments to build consensus among divergent interests and competing organizational needs.
• Able to lead and coach individuals with varying levels of experience. 
• Exemplifies organizational agility; is skilled at identifying solutions and solving translational problems.
• Possesses excellent written and verbal communication skills, spanning providers to system leaders. 
• Preferred: Expertise in provider group settings, ability to create presentations based on data analysis, familiar with health plan sales schedule, capability to interpret and present on matrix partner functions

If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.

For this position, we anticipate offering an annual salary of 92,900 - 154,800 USD / yearly, depending on relevant factors, including experience and geographic location.

This role is also anticipated to be eligible to participate in an annual bonus plan.

We want you to be healthy, balanced, and feel secure. That’s why you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k) with company match, company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, visit